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PubMed1982

Isoenzyme characterisation of Trichomonas vaginalis.

Clones of 32 strains of Trichomonas vaginalis isolated from patients attending a venereal diseases clinic were compared among themselves and with authentic Pentatrichomonas hominis on the basis of their isoenzyme patterns for eight enzymes by thin-layer starch-gel electrophoresis. The enzymes examined were: glucose phosphate isomerase (GPI); phosphoglucomutase (PGM); malic enzyme (NADP+) (ME); hexokinase (HK); malate dehydrogenase (NAD+) (MDH); glucose-6-phosphate dehydrogenase (G6PD); aldolase (ALD); and lactate dehydrogenase (LDH). From the isoenzyme patterns of four enzymes (LDH, MDH, HK, and GPI) the strains of T vaginalis could be divided clearly into five groups. PGM showed differences in only one strain, while two other enzyme patterns (ME and ALD) were the same for all the strains of T vaginalis tested. All isolates were clearly distinguishable from P hominis. Although G6PD patterns were not sharp some differences were evident among T vaginalis strains.

Animals↗
PubMed1982

Evaluation of an enzyme-linked immunosorbent assay for the detection of antibody to Trichomonas vaginalis in sera and vaginal secretions.

Using a whole-cell antigen antibody to Trichomonas vaginalis was measured by an enzyme-linked immunosorbent assay (ELISA). IgG antibody was found in sera from only three of 99 children under 12 years of age. In contrast, serum IgG or IgM antibody or both were detected in 80.4% of women who had vaginal trichomoniasis and in 13.7% of uninfected women. Although antibody was found in cervical and vaginal secretions, the correlation between current infection and the presence of antibody was poorer than found between circulating antibody and infection. IgG or IgA antibody or both was detected in the secretions of 73.2% and 41% of infected and uninfected women respectively. This may be accounted for, at least partly, by previous infections since antibody, circulating or local, was found most often in women who had a history of trichomoniasis. There was no indication that some other vaginal micro-organism stimulated antibody directed against T vaginalis.

Antibodies↗
PubMed1982

Metronidazole resistance of Trichomonas vaginalis as a cause of treatment failure in trichomoniasis--A case report.

Six isolates of a strain (MRP-MT) of Trichomonas vaginalis obtained from a woman before and after unsuccessful treatment with metronidazole had an appreciably lower susceptibility to metronidazole both in vitro in the aerobic tube assay and in vivo in the mouse assay than did control strains from patients cured with standard doses of the drug. Our results support recent evidence that metronidazole-resistant strains of T vaginalis do cause treatment failure. Resistance of these strains could be detected in vitro under only aerobic but not anaerobic conditions. The prevalence of metronidazole-resistant strains of T vaginalis should be kept under surveillance in order to estimate their clinical importance. The patient harbouring the resistant strain MRP-MT was finally cured with increased doses of ornidazole.

Adult↗
PubMed1983

Infection of female squirrel monkeys (Saimiri sciureus) with trichomonas vaginalis as a model of trichomoniasis in women.

Marmosets, tamarins, owl monkeys, and squirrel monkeys were inoculated intravaginally with Trichomonas vaginalis. The latter animal species was most susceptible, trichomonads being recovered from four of six monkeys for periods ranging usually up to one month. Vaginal discharge was seen in most infected animals but polymorphonuclear leucocytes were rare. Infected animals developed serum IgG antibody responses and also local IgG and IgA responses, the latter occurring sometimes on reinoculation in the absence of organism recovery. Antibody responses were, however, of short duration and, overall, immunity was weak because two animals were reinfected on a second or subsequent challenge. Some of the observations are relevant to vaginal trichomoniasis in women.

Animals↗
PubMed1984

Enzyme linked immunosorbent assay for detecting antibody to Trichomonas vaginalis: use of whole cells and aqueous extract as antigen.

An enzyme linked immunosorbent assay (ELISA) for detecting antibody to antigenic Trichomonas vaginalis macromolecules has been identified using whole cells or an aqueous protein extract as antigen. The test was developed under optimum conditions using serum samples from experimental animals. The sensitivity of the ELISA was equal to or greater than that obtained by radioimmunoprecipitation and electrophoresis-fluorography techniques. The ELISA was capable of assessing antibody responses during the development of lesions in animals inoculated subcutaneously and it reproducibly measured the individual classes immunoglobulins directed at T vaginalis. The colorimetric assay was also suitable for showing cross reactivity between trichomonal species as well as between different strains of T vaginalis. Conditions established for monitoring antibody to trichomanads in immunised rabbits or infected mice were equally effective for human materials, such as serum or vaginal washes. Serum from experimental animals or infected people showed high concentrations of IgG, IgA, and IgM antibody to trichomonads. Only antibodies of the IgG and IgA class were detected in vaginal washes from women with acute trichomoniasis. No IgE antibody to trichomonads was found under a variety of conditions in serum samples from patients or experimental animals.

Animals↗
PubMed1986

Immunotherapeutic effect of the lactobacillus vaccine, Solco Trichovac, in trichomoniasis is not mediated by antibodies cross reacting with Trichomonas vaginalis.

According to the producers of the lactobacillus vaccine, Solco Trichovac, its therapeutic effect in trichomoniasis is achieved by antibodies that are induced by the vaccination and cross react with Trichomonas vaginalis. Common antigens of Lactobacillus acidophilus from Solco Trichovac vaccine and T vaginalis were therefore sought by three different seroreactions. Immune serum against Lacidophilus obtained by vaccinating two healthy human volunteers and two rabbits with the original Solco Trichovac vaccine, as well as hyperimmune rabbit antiserum to T vaginalis, were tested with each of the two micro-organisms. No evidence of antigenic similarity between L acidophilus and T vaginalis was obtained with either serum in any of the three serological tests. A non-specific immunostimulatory effect therefore seems to be a more probable explanation of the mode of action of Solco Trichovac vaccine.

Adult↗
PubMed1988

Fewer Trichomonas vaginalis organisms in vaginas of infected women during menstruation.

The aims of the present study were to count Trichomonas vaginalis organisms recovered from the vaginas of patients with trichomoniasis, and to obtain data concerning changes in sizes of trichomonal populations during the menstrual cycle. In about 80% of symptomatic as well as symptomless patients, more than 1 x 10(5) parasites per ml could be obtained from vaginal washes. During menstruation, however, the number of trichomonads decreased appreciably, with subsequent increases within three to six days after bleeding. The results indicated that sufficient numbers of fresh trichomonads may be obtained from vaginal washes for biochemical and molecular experiments and also confirm the previously reported trichomonocidal effect of menstrual blood complement in vivo.

Adolescent↗
PubMed1989

Survival of Trichomonas vaginalis in human semen.

Although exposure of Trichomonas vaginalis to human semen is of short duration, any effect that this fluid may have on the urogenital protozoon could affect its transmission, especially if only few trichomonads are present. Small numbers of parasites (about 2500/ml semen) incubated in semen from different donors at 37 degrees C, were found to survive or grow for up to 12 hours in all samples and for up to 24 hours in most. Survival and growth of T vaginalis in semen most resembled that found in Diamond's trypticase, yeast extract, and maltose (TYM) medium without serum supplement, rather than in complete TYM medium and phosphate buffered saline. Contrary to previous reports, semen did not inhibit the survival of T vaginalis, and the presence of trichomonads did not alter motility or numbers of spermatozoa up to 24 hours. The data suggest that semen provides a favourable milieu for transmitting trichomonads.

Adult↗
PubMed1991

An evaluation of an InPouch TV culture method for diagnosing Trichomonas vaginalis infection.

A new culture method for Trichomonas vaginalis, the InPouch TV test, was evaluated for its sensitivity and specificity in supporting growth of trichomonads. Five clinical isolates remained viable for periods from 41 to 131 days. A strain from the ATTC 30001 remained viable for 91 days. As few as four trichomonads/ml of culture medium could be viewed microscopically within 24 h. Doubling time for growth of trichomonad varied between 5 to 8 h. In a clinical study of 102 wet-mount negative specimens, 15 culture positive patients were observed with the InPouch TV test compared with 12 of the same patients with Hollander's fluid medium.

Animals↗
PubMed1991

Antibody in sera of patients infected with Trichomonas vaginalis is to trichomonad proteinases.

BACKGROUND: A recent report demonstrated the immunogenic character of the cysteine proteinases of Trichomonas vaginalis. It was of interest, therefore, to examine for the presence of serum anti-proteinase antibody among patients with trichomoniasis. METHODS: An immunoprecipitation assay was used involving protein A-bearing Staphylococcus aureus first coated with the IgG fraction of goat anti-human Ig and then mixed with individual sera of patients to bind human antibody. These antibody-coated bacteria were then added to detergent extracts of T vaginalis. Bound immune complexes on S aureus were washed and solubilised for electrophoretic analysis on acrylamide copolymerised with gelatin for detection of proteinase activity. RESULTS: Sera from patients (50/50), but none from sera of normal, uninfected women, possessed IgG to numerous trichomonad cysteine proteinases. The presence of this serum anti-proteinase antibody disappeared after drug treatment and cure of patients of the T vaginalis infection. CONCLUSIONS: The commonality of the anti-proteinase antibody in the sera of patients with trichomoniasis provided evidence for the expression of the same repertoire of parasite proteinases during infection. These observations have important implications for the in vivo relevance of the proteinases and indicate that strategies to use a specific serum antibody response for diagnosis of this infection may be possible.

Animals↗
PubMed1993

Contact-independent cytotoxicity of Trichomonas vaginalis.

OBJECTIVE: To test the dependency of haemolytic and cytocidal manifestations of pathogenicity of Trichomonas vaginalis on direct contact between the target cells and the organism. TEST ORGANISM: T vaginalis strain Baltimore 42. DESIGN: Haemolysis in the presence of live T vaginalis and of its filter-sterilised metabolic products was compared. The dependence of haemolytic and cytocidal effects on retention of low pH of metabolic products of the organism was demonstrated by parallel titrations of sterile filtrates in normal saline and in phosphate buffered saline (PBS) pH 7.0. RESULTS: Near complete lysis was obtained when erythrocytes mixed with T vaginalis were incubated for 1 h at 37 degrees C in saline containing 1% glucose. The same degree of haemolysis was present in filter-sterilised glucose-saline in which the organism was incubated (1 h/37 degrees C) before erythrocytes were added and incubated under the same conditions as in the mixture with the organism. The degree of haemolysis in filtrates was dependent on retention of low pH (below 5.0) of the suspending fluid in which the organism alone was incubated. Dilution of filtrates in PBS, as opposed to normal saline, abolished or diminished the haemolytic effect. Presence of glucose (energy source) in the saline during incubation of the organism had a pronounced enhancing effect. The production of haemolytic metabolites was temperature dependent, whereas the haemolytic process per se was not. The effect was not an exclusive property of T vaginalis since it was also demonstrated with other trichomonads. The same filtrates applied to tissue culture exerted cytocidal effect strikingly similar to that observed in the haemolysis experiments. CONCLUSION: Neither haemolytic nor cytocidal effect of T vaginalis was contact-dependent.

Animals↗
PubMed1993

A comparison of yield from cervix versus vagina for culturing Candida albicans and Trichomonas vaginalis.

OBJECTIVE: To determine the agreement of culture results of Candida albicans and Trichomonas vaginalis from the cervix versus posterior fornix in women with vaginal symptoms. DESIGN: Same patient comparison of culture results from two sample sites. SETTING: Twenty one general practices in Amsterdam and the east of the Netherlands. SUBJECTS: Six hundred and eighty two women aged 15 to 55 years with vaginal symptoms, seen between 1 October 1987 and 31 May 1990. MAIN OUTCOME MEASURES: For each site (cervix and posterior fornix) the proportion of detected C albicans and T vaginalis. The sensitivity of the cervical swab related to the vaginal one. The percentage of concordance for both microorganisms. RESULTS: In 248 (34%) women C albicans was diagnosed and in 38 (6%) T vaginalis. In 99% of the proven C albicans cases, the yeast was found in the vagina. In 94% C albicans was isolated from the cervix. Sensitivity of the cervical swab was 94%. In 98% of the patients a concordant observation was made regarding detection of yeast. In 97% of the proven T vaginalis cases the protozoon was found in the vagina. In 91% T vaginalis was detected from the cervical swab. Sensitivity of the cervical swab was 92%. The culture results were concordant in 99%. CONCLUSION: The yield from the vaginal source was slightly better than that from the cervix for culture of both microorganisms. For screening purposes, specimen-collection for culture of N gonorrhoeae, C albicans and T vaginalis can be combined in one swab taken from the cervix.

Adolescent↗
PubMed1995

Serum antibodies to Trichomonas vaginalis in invasive cervical cancer patients.

OBJECTIVE: To evaluate, by seroepidemiology, the possible role of the sexually-transmitted flagellate, Trichomonas vaginalis, in invasive cervical cancer. SUBJECTS AND METHOD: Sera from 121 invasive cervical cancer patients and 242 random age-matched female controls. Antibodies to T. vaginalis were detected by the western blot technique. RESULTS: Antibodies to T. vaginalis were detected in the sera of 41.3% (50/121) of invasive cervical cancer patients compared with only 5.0% (12/242) of female controls. All the reactive sera reacted strongly with the immunogenic surface membrane proteins of T. vaginalis of molecular weights of about 92 and 115 kDa, with variable reactivity to other immunogenic proteins of T. vaginalis. CONCLUSION: The significantly increased relative risk, RR = 3.42 (95% CI = 1.73-6.78), is comparable to the RRs derived in seroepidemiological studies of human papillomavirus, suggesting that T. vaginalis may be even more closely associated with invasive cervical cancer than previously realized.

Adult↗
PubMed2002

The diagnosis of chlamydia, gonorrhoea, and trichomonas infections by self obtained low vaginal swabs, in remote northern Australian clinical practice.

OBJECTIVE: To examine the diagnostic performance of self obtained low vaginal swabs (SOLVS) and polymerase chain reaction (PCR) techniques in the diagnosis of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infection in a variety of clinical practice settings in remote north western Australia. DESIGN: A cross sectional field study of microbiological collection techniques in women undergoing gynaecological investigation in remote settings performed by a variety of practitioner types over 10 months. PARTICIPANTS AND SETTING: 349 women from remote towns and communities in the Kimberley region of north west Western Australia having gynaecological examinations for clinical reasons, well women screening, antenatal screening, and sexual health examinations. RESULTS: The overall prevalence of infection in the study population based on any positive conventional sample was 9.2%, 7.6%, and 16.1% for CT, NG, and TV respectively. The detection rates for CT and NG by SOLVS were 89% and 96% respectively, compared with 79% and 91% for endocervical swabs and 79% and 83% for first void urine. SOLVS had a sensitivity of 93% for TV detection, equal to that of clinician obtained low vaginal swabs. None of these differences reached statistical significance. A combination of SOLVS and first void urine detected 96% of the CT cases, 100% of the NG cases, and 96% of TV cases. CONCLUSIONS: Self obtained low vaginal swabs are an acceptable, simple and sensitive diagnostic sample for the detection of CT, NG, and TV, and have particular applications in remote clinical practice and as a screening technique.

Adult↗
PubMed2002

Predictors of infection with Trichomonas vaginalis: a prospective study of low income African-American adolescent females.

OBJECTIVES: To identify psychosocial predictors of Trichomonas vaginalis infection among low income African-American adolescent females living in a high risk urban area of the United States. METHODS: Baseline plus 6 and 12 month follow up data collected as part of an HIV prevention intervention trial were utilised. The baseline sample consisted of 522 African-American females, 14-18 years of age. Recruitment sites were located in low income neighbourhoods of Birmingham, Alabama, characterised by high rates of unemployment, substance abuse, violence, teenage pregnancy, and sexually transmitted infections. Self administered vaginal swab specimens were cultured for T vaginalis. Baseline measures collected as part of a self administered survey and face to face interviews were used to predict subsequent infection with T vaginalis at any of the three assessment periods conducted over the span of 1 year. RESULTS: At baseline, 12.9% were diagnosed with T vaginalis. At the 6 and 12 month follow ups, T vaginalis was diagnosed in 8.9% and 10.2%, respectively. The strongest multivariate predictor of T vaginalis infection was biologically confirmed marijuana use; those using marijuana were more than six times as likely to test positive for T vaginalis (adjusted odds ratio (AOR) = 6.2, p = 0.0003). Other multivariate predictors were reporting that typical sex partners were at least 5 years older (AOR = 2.6; p = 0.005), reporting sex with non-steady partners (AOR = 1.9; p = 0.02), and history of delinquency (AOR = 1.3; p = 0.02). The odds of testing positive increased by 31% for every one unit increase on a six item scale measure of delinquency. CONCLUSIONS: Infection with T vaginalis was common and significant multivariate predictors comprised a constellation of problem behaviours, each of which are potentially amenable to behavioural intervention.

Adolescent↗
PubMed2003

Use of urine polymerase chain reaction to define the prevalence and clinical presentation of Trichomonas vaginalis in men attending an STD clinic.

OBJECTIVE: To determine the prevalence and clinical features of Trichomonas vaginalis (TV) infection in men. METHODS: Men attending a public STD clinic in Baltimore, Maryland, were evaluated between March and July 2000. Clinicians recorded a standardised history and clinical examination. Urethral swab specimens were collected for Gram stain and Neisseria gonorrhoeae culture. First fraction urine samples were evaluated with TV culture and chlamydia and TV polymerase chain reaction (PCR). True positive TV was defined as a positive TV culture or a positive TV PCR confirmed with a second primer set. RESULTS: 355 men were evaluated in 363 visits. The prevalence of gonorrhoea, TV, and chlamydia were 19%, 13%, and 11%, respectively. In men over 28 years, the prevalence of TV was significantly higher than chlamydia. Age and urethritis by Gram stain were associated with a positive result on TV culture (p=0.03 and p=0.02, respectively) but not associated with TV infection as defined by a positive TV culture or a confirmed TV PCR. Discharge or dysuria was reported in 47% and 22% of men with TV, respectively. CONCLUSIONS: TV prevalence in an urban STD clinic setting was high. Older age and urethritis were not significantly associated with TV infection as defined by a positive TV culture or a confirmed TV PCR.

Adult↗
PubMed2003

Comparison of culture and different PCR assays for detection of Trichomonas vaginalis in self collected vaginal swab specimens.

OBJECTIVES: DNA amplification techniques have become widely used for the diagnosis of sexually transmitted infections. For the detection of Trichomonas vaginalis, PCR techniques are not yet widely used despite the publication of several assays. The sensitivity and specificity of five independent primer sets were determined on self collected vaginal specimens obtained from female commercial sex workers. METHODS: Self collected specimens were obtained from symptomatic and asymptomatic women attending a female sex workers clinic in Abidjan, Côte d'Ivoire. Two vaginal specimens were collected, the first one was processed for culture and the second was processed for PCR analysis. PCR techniques for trichomonads were performed, using the primers as reported by Riley (TVA5/TVA6), Kengne (TVK3/TVK7), Madico (BTUB 9/BTUB 2), Shiao (IP1/IP2), and Mayta (TV1/TV2). An EIA amplicon detection method was designed for each of the primer sets. RESULTS: True positive specimens were defined as culture positive and/or two positive PCR results with EIA amplicon detection in any combination. According to this definition a prevalence of 20% was obtained compared to 7% obtained by culture. The PCR primer set TVK3/TVK7 gave the highest sensitivity (89.2%). Poor sensitivities were obtained with the primer sets TV1/TV2 (60.2%) and TVA5/TVA6 (63.9%). PCR showed a sensitivity improvement of 2.4% up to 12% when EIA was used for amplicon detection. CONCLUSIONS: Overall, the sensitivities of the different PCR assays resulting from this study were lower than those previously described. These findings could be the result of the nature of the specimen population and suggests a strain variability.

Animals↗
PubMed1996

Pulmonary eosinophilia due to Trichomonas tenax.

A 39 year old woman was admitted with fever and an exacerbation of asthma. The chest radiograph showed extensive bilateral lung infiltrates, but transtracheal needle aspiration did not reveal any infectious organisms. The bronchoalveolar fluid lavage contained a large number of Trichomonas tenax and an increased percentage of eosinophils. Corticosteroids provided a dramatic response. Because of the relatively high frequency of colonisation of the human mouth by T tenax (about 20%), this organism should be considered in all cases of pulmonary eosinophilia.

Adult↗